Provider Demographics
NPI:1639153414
Name:GOMEZ, HERMAN I (MD)
Entity Type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:I
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-887-4600
Mailing Address - Fax:617-887-4646
Practice Address - Street 1:151 EVERETT AVE
Practice Address - Street 2:CHELSEA HEALTHCARE CENTER
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-1812
Practice Address - Country:US
Practice Address - Phone:617-887-4600
Practice Address - Fax:617-887-4646
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2014-02-14
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Provider Licenses
StateLicense IDTaxonomies
MA151795207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA772729OtherTUFTS HEALTH PLAN
MA3168425Medicaid
MAJ17856OtherBCBS MA
MAJ17856OtherBCBS MA
MAA22807Medicare PIN